Pericardial Effusion as a Complication of PICC Line Insertion

2021 ◽  
pp. 097321792110076
Author(s):  
Abdah Hrfi ◽  
Mohammed H.A. Mohammed ◽  
Omar Tamimi
Keyword(s):  
Birth Weight ◽  
Pericardial Effusion ◽  
Metabolic Diseases ◽  
Neonatal Period ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Preterm Baby ◽  
Line Insertion ◽  
Uncommon Condition ◽  
Picc Line

Cardiac tamponade as a result of pericardial effusion (PE) is a serious uncommon condition in the neonatal period. PE in such cases could be associated with hydrops fetalis, neonatal sepsis, metabolic diseases, or as a complication of percutaneous indwelling central catheter. 1 We are reporting a preterm baby, with low birth weight who developed large PE as a complication of total parenteral nutrition via a peripherally inserted central catheter, managed successfully with pericardiocentesis.

Application of Electrocardiogram Localization during Peripherally Inserted Central Catheter Line Insertion into the Persistent Left Superior Vena Cava of Neonates

2021 ◽  
Author(s):  
Liyuan Wu ◽  
Lijia Wan ◽  
Min Peng ◽  
Tian Cao ◽  
Qin Wang ◽  
...  
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
P Wave ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Characteristic P ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Line Insertion ◽  
Picc Line

Background Most neonates with persistent left superior vena cava (PLSVC) have no clinical symptoms or hemodynamic changes, and this anomaly is only found during cardiac catheterization, pacemaker implantation, or central venous catheterization. Electrocardiogram (ECG) localization is helpful for the application of the peripherally inserted central catheter (PICC) technique in neonates with PLSVC. Objective To explore the characteristic waveforms of the P wave when a PICC under ECG localization is applied in neonates with PLSVC. Study Design The observation and management strategies for the P wave changes during catheter insertion (CI) of two neonates with PLSVC admitted to our institution between January and July 2020, who underwent PICC line insertion, were summarized. Results The characteristic P wave changes in two children with a PICC line inserted via the PLSVC were observed. When a wide inverted P wave appeared on ECG, the catheter was immediately withdrawn by 0.5 cm, a bidirectional P wave gradually appeared and then disappeared. After that, the catheter was further withdrawn by 0.5 cm. After catheterization, the optimal position of the PICC was confirmed by X-ray photography and bedside B-ultrasound. The PICC line was removed as scheduled after indwelling for 18 and 29 days, respectively, in the two cases, and no PICC-related complications occurred during indwelling. Conclusion The characteristic P wave changes on ECG during CI provide important clinical reference values for the application of the PICC technique under ECG localization in neonates with PLSVC. Key Points

scholarly journals A dedicated peripherally inserted central catheter (PICC) line service: 2 Year review

2013 ◽  
Vol 11 (8) ◽  
pp. 649
Author(s):  
N.D. Appleton ◽  
A. Corris ◽  
C. Edwards ◽  
A. Kenyon ◽  
C.J. Walsh
Keyword(s):  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Picc Line

scholarly journals Cateter central de inserção periférica e dissecção venosa em bebês: estudo descritivo

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Keline Soraya Santana Nobre ◽  
Maria Vera Lúcia Moreira Leitão Cardoso ◽  
Juliana Lopes Teixeira ◽  
Márcia Maria Coelho Oliveira Lopes ◽  
Fernanda Cavalcante Fontenele
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Quantitative Study ◽  
Neonatal Unit ◽  
Northeastern Brazil ◽  
Maternity Unit ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Catheter Tip

Aim:  analyze  the  use  of  peripherally  inserted  central  catheter  in terms of the aspects of technique, positioning and maintenance, as well as the influence on the number of venous dissections in hospitalized infants in a neonatal unit. Method: descriptive,  retrospective,  quantitative  study,  in  reference  maternity  unit  of  a  city  in northeastern  Brazil.  Sample  composed  of  1,599  peripherally  inserted  central  catheter insertions in 1,204 infants during the years 2006 to 2013. Instruments were used that recorded  aspects  of  the  insertion  of  peripherally  inserted  central  catheter  and  venous dissection.  Results:  most  babies  were  premature,  of  low  birth  weight  and  male.  The veins  of  the  cubital  region  were  the  most  punctured  with  insertion  success  until  the fourth  puncture.  The  central  positioning  of  the  catheter  tip predominated,  with  a permanency  time  between  11  and  20  days,  removing  it  at  the  end  of  the  treatment. Over  the  years,  the  number  of  venous  dissections  was  inversely  proportional  to  the insertion  of  peripherally  inserted  central  catheter.  Conclusion:  this  transvenous  device was  shown  to  be  important  for  the  treatment  of  hospitalized  newborns,  favoring reduction of venous dissections.

The Role of a Single Dose of Vancomycin in Reducing Clinical Sepsis in Premature Infants Prior to Removal of Peripherally Inserted Central Catheter: A Retrospective Study

2018 ◽  
Vol 35 (10) ◽  
pp. 990-993
Author(s):  
Lovya George ◽  
Michael Malloy ◽  
Rafael Fonseca ◽  
Vidit Bhargava
Keyword(s):  
Single Dose ◽  
Premature Infants ◽  
Exposed Group ◽  
P Value ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Clinical Sepsis ◽  
Picc Line ◽  
Culture Positive

Objective Peripherally inserted central catheter (PICC) line removal is associated with bloodstream infections and clinical sepsis. We aim to investigate the role of a single prophylactic dose of vancomycin in decreasing the incidence of central line associated bloodstream infection associated with PICC removal. Methods A retrospective chart review of patients in the neonatal intensive care unit was conducted. Patients were divided into two study groups based on whether a single dose of vancomycin was administered (exposed) or not (nonexposed). The primary outcome measured was clinical sepsis with or without positive blood culture. Results The incidence of clinical sepsis in the exposed group was 7.3% compared with 6.3% in the nonexposed group (p-value: 0.7860). The incidence of culture-positive sepsis in the exposed group was 2.2% compared with 1.6% in the nonexposed group (p-value: 0.7673). The overall incidence of clinical and culture-positive sepsis in the subgroup with infants weighing <1,500 g and <32 weeks' gestational age was similar to the main study group. Conclusion Our data do not support routine vancomycin prophylaxis prior to PICC line removal in premature infants to prevent sepsis associated with PICC removal. However, a large randomized controlled trial is further needed to delineate these results.

scholarly journals Persistent Left Superior Vena Cava Identified during Peripherally Inserted Central Catheter Line Placement

2019 ◽  
Vol 5 (02) ◽  
pp. 64-66
Author(s):  
Arvind Borde ◽  
Vivek Ukirde
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Left Superior Vena Cava ◽  
Anatomical Variant ◽  
Persistent Left Superior Vena ◽  
Line Placement ◽  
Picc Line

Abstract Introduction A persistent left superior vena cava (SVC) is found in 0.3 to 0.5% of the general population. It is seen in up to 10% of the patients with a congenital cardiac anomaly, being the most common thoracic venous anomaly, and is usually asymptomatic. Being familiar with such anomaly could help clinicians avoid complications during the placement of central lines, Swan-Ganz catheters, peripherally inserted central catheter (PICC) lines, dialysis catheters, defibrillators, and pacemakers. Case Presentation We describe a case of persistent left SVC which was noted after placement of a PICC line. A 5-year-old male child was hospitalized for evaluation and management of leukemia. He required PICC line placement for chemotherapy. He was noted to have a persistent left SVC during the procedure under fluoroscopic guidance and subsequently correct placement of PICC line in right SVC. Discussion This anatomical variant can pose iatrogenic risks if the clinician does not recognize it. A central catheter that tracks down the left mediastinal border may also be in the descending aorta, internal thoracic vein, superior intercostal vein, pericardiophrenic vein, pleura, pericardium, or mediastinum. Conclusion Our case is significant because the patient was diagnosed with double SVC on table only followed by the placement of PICC line into the right SVC. This case strongly demonstrates the importance of knowing the thoracic venous anomalies.

The Wandering Ways of a PICC Line: Case Report of a Malpositioned Peripherally Inserted Central Catheter (PICC) and Correction

2011 ◽  
Vol 16 (4) ◽  
pp. 218-220 ◽  
Author(s):  
J. Patricia Catudal ◽  
Elizabeth L. Sharpe
Keyword(s):  
Trisomy 21 ◽  
Term Infant ◽  
Infusion Therapy ◽  
Team Approach ◽  
X Rays ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Congenital Cardiac Anomalies ◽  
Picc Line ◽  
Central Catheters

Abstract Peripherally Inserted Central Catheters (PICC) are essential in modern infusion therapy. We describe a case of a full-term infant with Trisomy 21, congenital cardiac anomalies and sepsis, where the PICC became malpositioned. Noninvasive repositioning strategies were successfully utilized through a team approach, which enabled this unstable infant to complete their therapy course without the undue stress of inserting a new PICC or requiring additional X-Rays or more invasive replacement procedures.

Peripherally Inserted Central Catheter-Induced Right Atrium Thrombosis and Superior Vena Cava Dissection

2017 ◽  
Vol 22 (1) ◽  
pp. 20-21
Author(s):  
Priyank Shah ◽  
Rahul Vasudev ◽  
Raja Pullatt ◽  
Fayez Shamoon
Keyword(s):  
Pulmonary Embolism ◽  
Superior Vena Cava ◽  
Rare Complication ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Access ◽  
Right Atrial ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Picc Line

Abstract A 42-year-old woman with past medical history of intravenous drug abuse was admitted to hospital with fever and heart murmur. A peripherally inserted central catheter (PICC) was inserted because the patient had poor venous access. Transesophageal echocardiography was done to rule out infective endocarditis. The test showed thrombus attached to the PICC line. Thrombus arising from a catheter is known complication of PICCs. Classifications of right heart thromboembolism (RHTE) are based on morphology. Type A thrombi are highly mobile and may prolapse through the tricuspid valve. Conversely, type B thrombi are attached to the right atrial or ventricular wall and may originate in association with foreign bodies or in structurally abnormal chambers. RHTEs are associated with pulmonary embolism in approximately 4%–6% of cases and increase the 3-month mortality rate from 16% to 29%. On echocardiography, partial dissection of the superior vena cava (SVC) was also noted. This is a very rare complication of PICC. To the best of our knowledge this is the first reported case of PICC-induced thrombosis with partial dissection of SVC. The PICC line was removed and echocardiography postremoval did not show any thrombus. The patient remained asymptomatic without any signs of hemodynamically significant pulmonary embolism. SVC dissection was also managed conservatively. Use of central venous catheters in clinical practice is increasing but it is not a benign procedure. It may be associated with serious complications.

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